Patient Education
Pneumatic Retinopexy
In-office · about 30 minutes, plus days of positioning at home
Pneumatic retinopexy repairs certain retinal detachments without going to the operating room. A small gas bubble is injected into the eye, and by holding your head in a specific position you float that bubble against the detached retina, pressing it flat while laser or cryotherapy seals the tear that caused the problem.
Pneumatic retinopexy repairs certain retinal detachments without going to the operating room. A small gas bubble is injected into the eye, and by holding your head in a specific position you float that bubble against the detached retina, pressing it flat while laser or cryotherapy seals the tear that caused the problem. It works well for selected detachments — typically a single tear or a cluster of tears in the upper part of the retina, in an eye without significant scar tissue. Your positioning at home is as much a part of the treatment as anything done in the office.
What to Expect
Before
A careful dilated exam, often with wide-field imaging, confirms the tear is in a position the bubble can reach and that there is no scar tissue that would keep the retina from settling. The eye is numbed with an injection and cleaned with antiseptic.
During
A small amount of expansile gas is injected into the vitreous cavity. The tear is sealed with cryotherapy or laser, either at the same visit or a day or two later once the retina has flattened. Your eye pressure is checked, and a small amount of fluid is sometimes released to keep it in a safe range.
After
You will see the bubble as a dark, wobbling dome that moves when you move. It shrinks over days to weeks and the line across your vision drops as it goes. Positioning begins immediately, and you will usually be seen the next day.
Recovery & Restrictions
- Head positioning is the treatment. You will be asked to hold a specific position for most of your waking hours for roughly five to seven days. Your team will demonstrate the exact position — it is not simply face-down.
- You cannot fly, and you must not travel to high altitude, while gas remains in your eye. Altitude expands the bubble and can raise the pressure inside your eye to a dangerous level. This restriction lasts until the bubble is completely gone — up to about two months with the longer-acting gas.
- Tell any anesthesiologist or surgeon that you have a gas bubble in your eye. Nitrous oxide anesthesia is dangerous while gas is present. Many patients are given a wristband to wear.
- Vision through the bubble is very poor. This is expected and improves as the bubble absorbs.
- Expect frequent follow-up — often the next day, then again within the week — because early detection of a new tear is what allows it to be handled easily.
Risks & Side Effects
New tears or a new detachment
The most significant risk. New breaks can form as the retina settles and the gas moves, and they may require a formal operation. This is the main reason for close early follow-up.
Needing surgery anyway
Pneumatic retinopexy succeeds with a single procedure less often than vitrectomy or a scleral buckle. When it fails, the retina is usually repaired successfully with surgery afterward, but you will have gone through both.
Gas in the wrong place
Gas can occasionally pass under the retina or become trapped, which complicates the repair and may require additional intervention.
Raised eye pressure
The bubble takes up space and can push pressure up, particularly in the first hours. Pressure is checked before you leave and at follow-up.
Scar tissue on the retina (PVR)
Scar tissue can contract and re-detach the retina weeks later. It is the most difficult complication of any detachment repair, and it can occur regardless of which method is used.
Every procedure carries risk, and this list is not exhaustive. Your doctor will discuss the risks that apply to your eye and your circumstances before you decide.